Provider Demographics
NPI:1326217183
Name:RUIZ, ELIZABETH (SLP-CCC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:RUIZ
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 HOUSTON WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-3247
Mailing Address - Country:US
Mailing Address - Phone:956-784-2053
Mailing Address - Fax:
Practice Address - Street 1:903 N FLAG ST
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-2912
Practice Address - Country:US
Practice Address - Phone:956-784-2053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24803235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist